ULTRASONOGRAPHIC EVALUATION OF GALLBLADDER VOLUME AND ITS RELATION WITH AUTONOMIC NEUROPATHY IN DIABETIC PATIENTS OF JHARKHAND

Introduction: Diabetes mellitus is the most common endocrine disorder of humans characterized by metabolic abnormalities leading to long term complications. Neuropathy is one of the common complications of diabetes. Despite being a well-known consequence, autonomic neuropathy has received less attention than other microvascular sequelae. The involvement of both parasympathetic and sympathetic chains in autonomic neuropathy results in a variety of manifestations affecting various body organs. Gallbladder involvement in diabetic autonomic neuropathy is in the form of high incidence of gallstones and a signicant increase in gallbladder volume with lack of symptoms of gallbladder disease. The study was conducted on 150 Materials & Methods: known diabetic patients and 150 age and sex matched controls. After detailed history, cardiac autonomic function is assessed by simple bedside tests and CAN score was assigned as per Ewing and Clarke's criteria. Ultrasound is used to assess the fasting gallbladder volume after 8 hours of fasting and postprandial gallbladder volume after xed standard fatty meal. The results are analysed using MS-EXCEL, SPSS and MedCalc software. p value<0.05 was taken as statistically signicant. The fasting gallbladder volume in s Results: tudy group was 33.96 ± 15.19 as compared to 24.79 ± 9.96 in controls. Postprandial volume in study group was 24.01 ± 14.41 as compared to 16.28 ± 9.01 in controls. The difference was statistically signicant. 120 patients in cases show some degree of autonomic neuropathy as compared to 65 patients in control group. Correlation of GBV with different parameters like HbA1c had Pearson's correlational coefcient (r) = 0.430, correlation with duration of diabetes had r = 0.391, correlation with CAN scoring had r = 0.757, correlation with microalbuminuria had r = 0.299. All results were statistically signicant with pvalue<0.05. However, correlation of GBV with age had (r) =0.0033, Correlation with BMI shows r=0.152 both results were statistically insignicant. Autonomic neuropathy was more prevalent in hypertensive subjects but result was statistically insignicant. The Conclusion: fasting and PP-gallbladder volume was higher in study subjects due to autonomic neuropathy. Correlation of GBV with glycemic control, duration of diabetes, Cardiac autonomic neuropathy shows a positive correlation, whereas correlation of autonomic neuropathy with Age, BMI and hypertension was statistically insignicant.